In the very beginning, I must admit, there was a small bit of a thrill inside me: “I’m joining the war against SARS CoV-2…I’m part of the fight in this global pandemic.” People all across the world stood up to thank us, whether banging pots and pans from their windows, or sending us cards, posters, and treats. While we are not in it for the praise, the praise was nice nonetheless.

Almost two years into this pandemic, I must say that thrill is gone.

In my entire career, I have never experienced the scale of death and destruction by one condition. I was in practice during the 2009 H1N1 pandemic; I have worked many bad influenza seasons. All of those pale in comparison to the SARS CoV-2 pandemic. It has been horrific.

There are scenes in my head that can never be unseen. Patient after patient after patient has died – many times alone in the ICU with their families screaming in anguish on an iPad. We are exhausted, physically, mentally, and emotionally.

We had thought that, with the advent of vaccines, it would be the beginning of the end. Indeed, tens of millions of us have gotten vaccinated, and in the beginning of the summer of 2021, it seemed like it was over.

But there were also tens of millions of us who didn’t want to get vaccinated, even though the vaccines are incredibly safe, incredibly effective, widely available, and free of charge to boot. And when Delta hit our shores, the anguish started all over again.

Hospitals and ICUs were, once again, overwhelmed with COVID-19 patients. Once again, tents were erected outside of Emergency Rooms. Once again, resources were running thin. In one of my hospitals, we came dangerously close to running out of ventilators. In some parts of our country, fellow colleagues had to choose which patient would live or die. I never though it would be like this – again – in the summer of 2021. But, it was, and we are exhausted.

And now, way more than before, the patients coming in with COVID-19 – the overwhelming majority of whom are not vaccinated – are younger. And, they are dying.

What’s more, many of them are angry and belligerent towards us. What did we do? Why are you taking our your frustrations out on us? We are angry, too, but we would never take it out on our patients, who come to us seeking our help to relieve their suffering. It’s been a terrible road, and we are exhausted.

And, like I said, the virus is not yet done with us. I genuinely fear this winter, where we may very well have “Revenge of the Flu” along with a steady stream of new COVID-19 patients. It may very well get worse before it gets better. But, we don’t have much left to give. We are done with this virus, and we are exhausted.

And so, as we soldier on, all I can say is, “Thank You.”

From the very bottom of my heart and soul, I say “Thank You.” Thank you, my sisters and brothers on the front lines, for all you have done. Thank you, my sisters and brothers, for your fatigue. Thank you, my sisters and brothers, for your exhaustion. Thank you, my sisters and brothers, for your exasperation.

This pandemic has tested us to our very cores, and I pray that we will come out of it much better caregivers and much better people, our emotional scars notwithstanding.

If I said “Thank You,” my sisters and brothers, for eternity it would not be enough. But still, let me say, one more time, “Thank You.” You are all so special to me, and you will always be in my heart and my prayers.

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It is consistently working to improve the delivery of medical care, as well as better understand issues pertaining to public health, as evidenced by its work to maintain the International Classification of Diseases (ICD), a diagnostic tool for epidemiology and disease classification. Similar to other diagnostic tools such as the DSM, it is one that has been frequently updated over the years to reflect the latest research.

One of the more recent updates to the ICD saw a more thorough classification of the concept of ‘burnout’, for example. It is now recognized as a syndrome, resultant from “chronic workplace stress that has not been successfully managed”. It is important to note that this applies explicitly to an occupational context. Burnout is something that can be seen across a wide array of industries; however, physician burnout is one that is of increasing concern in the wake of the pandemic.

As many states and cities across the globe are seeing new surges in coronavirus cases, hospitals and healthcare providers continue to grapple with the dynamics of the pandemic. Many are facing shortages of essential Personal Protective Equipment (PPE) and other medical supplies, despite being months into the pandemic.

Although some supply chains for different goods have adjusted, the healthcare industry is still plagued by deficiencies. This has critical implications. Without the needed supplies, healthcare providers risk unnecessary exposure for themselves, their patients, and their families. This, coupled with the increased amount of patients, is a recipe for stress, and eventual burnout, for many physicians.

Medscape’s 2020 ‘National Physician Burnout & Suicide Report’ found that 42% of the 15,000 physicians surveyed reported being burned out. Half of those surveyed said they would give up at least $20,000 in annual income to reduce their working hours. This was released in January, just months before the WHO had declared the novel coronavirus a global pandemic. The situation has only become worse, as hospitals are often understaffed or otherwise ill-equipped to handle the new demands on the healthcare system as a result of COVID-19.

Physicians are combatting the novel coronavirus, as well as fighting for their mental wellness. It is essential that we raise awareness of mental health for everyone, especially for those upon whom we all rely on our well-being. Doctors around the world are thankfully taking notes and researching ways to help provide interventions to help ease the burden. For the sake of all providers and their patients, let us hope this sheds more light on the issue and leads to actionable change.

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